压力接种训练联合结构式心理干预对老年心脏瓣膜置换术患者希望水平、自我感知压力及生存质量的影响

Effect of stress inoculation training combined with structural psychological intervention on hope level,self-perceived stress and quality of life in elderly patients undergoing heart valve replacement

目的:观察压力接种训练联合结构式心理干预对老年心脏瓣膜置换术患者希望水平、自我感知压力及生存质量的影响。方法:选取2020年4月-2023年4月110例老年心脏瓣膜置换术住院患者为研究对象,按随机数字表法分为干预组、对照组各55例。对照组接受结构式心理干预,干预组采取压力接种训练联合结构式心理干预,共8周。评价两组患者术后服药依从性;采用汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)评价患者心理状态,Herth希望指数(HHI)评价希望水平,自我感受负担量表(SPBS)评价自我感知压力,明尼苏达心功能不全生命质量量表(MLHFQ)评价生存质量。结果:干预组服药总依从率94.55%,较对照组的81.82%更高(χ^(2)=4.274,P<0.05);干预后8周,干预组HAMA、HAMD评分均低于对照组(t=-6.483,-5.450;P<0.05),HHI评分中对现实/未来的积极态度、采取积极行动、与他人保持亲密关系及总分均高于对照组(t=5.901,4.308,4.321,5.886;P<0.05),SPBS评分中身体负担、情感负担及总分均低于对照组(t=-3.622,-4.119,-3.701;P<0.05),MLHFQ评分中身体领域、情绪领域、其他领域及总分均低于对照组(t=-5370,-3.849,-4.311,-5.288;P<0.05)。结论:老年心脏瓣膜置换术患者采用压力接种训练联合结构式心理干预能改善患者心理状态、提升希望水平、减轻自我感知压力,有利于提高患者服药依从性、改善生命质量。

Objective:To observe the effect of stress inoculation training combined with structural psychological intervention on hope level,self-perceived stress and quality of life in elderly patients with heart valve replacement.Methods:A total of 110 elderly patients with heart valve replacement from April 2020 to April 2023 were selected as the study subjects and were divided into intervention group and control group with 55 cases in each group according to the random number table method.The control group received structural psychological intervention,and the intervention group was given stress inoculation training combined with structural psychological intervention,and both groups were intervened for 8 weeks.The postoperative medication compliance in the two groups was evaluated.Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)were used to evaluate the psychological status of patients.Herth Hope Index(HHI)was used to assess the hope level,and Self-Perceived Burden Scale(SPBS)was used for self-perceived stress assessment,and Minnesota Living with Heart Failure Questionnaire(MLHFQ)was adopted to evaluate the quality of life.Results:The total medication compliance rate in intervention group was 94.55%,which was higher than 81.82% in control group(χ^(2)=4.274,P<0.05).At 8 weeks after intervention,the scores of HAMA and HAMD in intervention group were lower than those in control group(t=-6.483,-5.450;P<0.05),and the scores of positive attitude towards reality/future,taking positive actions and maintaining close relationship with others and total score of HHI were higher than those in control group(t=5.901,4.308,4.321,5.886;P<0.05),and the scores of physical burden and emotional burden and total score of SPBS were lower than those in control group(t=-3.622,-4.119,-3.701;P<0.05),and the scores of physical field,emotional field and other fields and total score of MLHFQ were lower than those in control group(t=-5370,-3.849,-4.311,-5.288;P<0.05).Conclusion:Stress inoculation training combined with structural psychological intervention in elderly patients with heart valve replacement can improve the psychological status,enhance the hope level,relieve the self-perceived stress,and help to improve the medication compliance and quality of life.